Page 3715 - Week 10 - Tuesday, 26 August 2008
and the Human Rights Commission. Importantly, it included some senior ACT health professionals. The bill seeks to implement the proposals agreed to. The two layers of the consultation process undertaken ensure that appropriate consideration was given to the policy and practical aspects of the proposals. I am confident, therefore, that the scheme under the bill can easily be accommodated within the hospital system, and that it would be welcomed by the ACT community.
I am pleased to note that members agree that the measures the bill proposes safeguard the interests of the patients who cannot consent to treatment. A medical practitioner and a health attorney acting under the new scheme must follow the decision-making principles set out in the Guardianship and Management of Property Act. Briefly, some of these key principles are that: the protected person’s wishes, as far as they can be worked out, must be given effect without significantly adversely affecting the person’s interests; if the protected person’s wishes cannot be given effect at all, the decision-maker must promote the person’s interests; and the protected person’s life, including their lifestyle, must be interfered with to the smallest extent necessary.
When selecting a health attorney, a health professional will be obliged to: ask for the consent required for medical treatment from a health attorney who he or she believes on reasonable grounds is the best able to represent the views of the protected person; consider the health attorneys for the protected person in the priority order, which I will explain shortly; and not use a health attorney if the health professional believes on reasonable grounds the health attorney is unsuitable.
The priority order amongst health attorneys is: first the patient’s domestic partner; second a carer for the patient; and, third, a close relative or close friend of the patient. A carer would be someone who gives or arranges the giving of care and support to protect a person in a domestic context. A domestic partner is clearly someone who must have a close and continuing relationship with the protected person, and a close relative or friend must have a close personal relationship with the protected person.
The circumstances in which a health professional would believe a health attorney not to be suitable would be, for example, if the health professional becomes aware that the health attorney is under undue influence or the interests of the health attorney and the protected person are in conflict. The health professional must record the reasons for his or her belief as to why a particular health attorney is not suitable.
The bill also requires a health professional to provide specified information to a health attorney, for example, the health professional should set out the reasons why a person is a protected person, the condition of the protected person, the medical treatment for which consent is sought, any alternative treatment that is available, the nature and likely effect of the medical treatment for which consent is sought, any alternative medical treatment and the decision-making principles. This information will ensure that the consent of a health attorney is informed.
The Public Advocate has a significant reserve role in the health attorney scheme. A health professional may not be able to find a suitable health attorney for a protected person. In that case, the health professional may contact the Public Advocate. It is not necessary for the bill to expressly provide for this. If a selected health attorney refuses